Displaying 87901-87910 of 1611142 results.
ID:
87901
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
308212
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
87902
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
403810
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
87903
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
403811
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
87904
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806195
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
87905
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806179
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
87906
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806183
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
87907
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
308191
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
87908
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
199119
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
87909
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
864110
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
87910
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
854302
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
87901879028790387904879058790687907879088790987910